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大麻二酚预防药物滥用复发的独特治疗潜力:临床前原理验证。

Unique treatment potential of cannabidiol for the prevention of relapse to drug use: preclinical proof of principle.

机构信息

Department of Neuroscience, The Scripps Research Institute, 10550 North Torrey Pines Road (SP30-2120), La Jolla, CA, 92037, USA.

Department of Psychology, European University of Madrid, School of Biomedical Sciences, Madrid, 28670, Spain.

出版信息

Neuropsychopharmacology. 2018 Sep;43(10):2036-2045. doi: 10.1038/s41386-018-0050-8. Epub 2018 Mar 22.

Abstract

Cannabidiol (CBD), the major non-psychoactive constituent of Cannabis sativa, has received attention for therapeutic potential in treating neurologic and psychiatric disorders. Recently, CBD has also been explored for potential in treating drug addiction. Substance use disorders are chronically relapsing conditions and relapse risk persists for multiple reasons including craving induced by drug contexts, susceptibility to stress, elevated anxiety, and impaired impulse control. Here, we evaluated the "anti-relapse" potential of a transdermal CBD preparation in animal models of drug seeking, anxiety and impulsivity. Rats with alcohol or cocaine self-administration histories received transdermal CBD at 24 h intervals for 7 days and were tested for context and stress-induced reinstatement, as well as experimental anxiety on the elevated plus maze. Effects on impulsive behavior were established using a delay-discounting task following recovery from a 7-day dependence-inducing alcohol intoxication regimen. CBD attenuated context-induced and stress-induced drug seeking without tolerance, sedative effects, or interference with normal motivated behavior. Following treatment termination, reinstatement remained attenuated up to ≈5 months although plasma and brain CBD levels remained detectable only for 3 days. CBD also reduced experimental anxiety and prevented the development of high impulsivity in rats with an alcohol dependence history. The results provide proof of principle supporting potential of CBD in relapse prevention along two dimensions: beneficial actions across several vulnerability states and long-lasting effects with only brief treatment. The findings also inform the ongoing medical marijuana debate concerning medical benefits of non-psychoactive cannabinoids and their promise for development and use as therapeutics.

摘要

大麻二酚(CBD)是大麻的主要非精神活性成分,因其在治疗神经和精神疾病方面的潜在治疗作用而受到关注。最近,CBD 也被探索用于治疗药物成瘾的潜在用途。物质使用障碍是一种慢性复发性疾病,由于多种原因,包括药物环境引起的渴望、对压力的易感性、焦虑增加和冲动控制受损,复发性持续存在。在这里,我们评估了一种透皮 CBD 制剂在药物寻求、焦虑和冲动性动物模型中的“抗复发”潜力。有酒精或可卡因自我给药史的大鼠在 24 小时间隔内接受透皮 CBD 治疗 7 天,并进行药物环境和应激诱导的复吸、高架十字迷宫上的实验性焦虑以及冲动行为的测试。在从为期 7 天的酒精致依赖诱导方案中恢复后,使用延迟折扣任务来确定冲动行为的影响。CBD 减弱了环境诱导和应激诱导的药物寻求,而没有产生耐受性、镇静作用或干扰正常的动机行为。治疗终止后,复吸仍被抑制长达 ≈5 个月,尽管在仅 3 天内仍可检测到血浆和大脑中的 CBD 水平。CBD 还降低了有酒精依赖史的大鼠的实验性焦虑,并防止了高冲动性的发展。这些结果提供了 CBD 在预防复发方面的原理证明,具有跨多个脆弱性状态的有益作用和仅短暂治疗即可产生的长期作用。这些发现还为正在进行的关于非精神活性大麻素的医学益处及其作为治疗剂的开发和使用的医用大麻辩论提供了信息。

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